Mothers with intellectual and developmental disabilities (IDD) experience socio-economic and health disparities which could impact their offspring's health care utilisation. We systematically reviewed evidence on health care utilisation in infants and young children of women with and without IDD.MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from inception to October 2019 for studies examining preventive care, immunisations, emergency department visits, and hospitalisations. Data extraction and quality assessment were performed using standardised tools. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were generated using random effects models for outcomes with data available from ≥3 studies.Four articles describing three cohort studies and one cross-sectional study met our criteria. Maternal IDD status was associated with increased neonatal intensive care unit admission rates (pooled OR 2.03; 95% CI 1.31, 3.13). There were no differences in immunisation rates or hospitalisations.Few studies have examined the impact of maternal IDD status on health care utilisation in their infants and young children. More high-quality studies are needed.
Women with disabilities are at elevated risk for pregnancy, delivery, and postpartum complications. However, there has not been a synthesis of literature on the neonatal and infant health outcomes of their offspring.We examined the association between maternal disability and risk for adverse neonatal and infant health outcomes.Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, and PsycINFO were searched from database inception to January 2020.Studies were included if they reported original data on the association between maternal physical, sensory, or intellectual and/or developmental disabilities and neonatal or infant health outcomes; had a referent group of women with no disabilities; were peer-reviewed journal articles or theses; and were written in English.We used standardized instruments to extract data and assess study quality. DerSimonian and Laird random effects models were used for pooled analyses.Thirty-one studies, representing 20 distinct cohorts, met our inclusion criteria. Meta-analyses revealed that newborns of women with physical, sensory, and intellectual and/or developmental disabilities were at elevated risk for low birth weight and preterm birth, with smaller numbers of studies revealing elevated risk for other adverse neonatal and infant outcomes.Most studies had moderate (n = 9) or weak quality (n = 17), with lack of control for confounding a common limitation.In future work, researchers should explore the roles of tailored preconception and perinatal care, along with family-centered pediatric care particularly in the newborn period, in mitigating adverse outcomes among offspring of women with disabilities.
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